Chief Complaint
|
|
Location
• • •
|
Location Comments
|
Quality
• • •
|
Quality Comments
|
Severity
|
Severity Comments
|
Duration pt 1
• • •
|
Duration pt. 2
• • •
|
Duration pt. 3
|
Duration Comments
|
Timing
• • •
|
Timing Comments
|
Context
• • •
|
Context comments
|
Assoc. symptoms
• • •
|
Assoc. sxs free text
|
Modifying factors
• • •
|
Mod factors comments
|
Previous Treatment
|
|